The discussion about basis vs advanced airway decision-making is a big one. Here is my take on it.
(Lockey et al., 2015)
England assessed the need for airway management in the prehospital setting and looked at success rates on arrival of doctor-paramedic teams.
Intubation success rate of 64% (significant complications), \ SAD success rate of 92%
Doctor-paramedic teams achieved definitive aam (WITH RSI)
First of it’s kind, blood from mouth, not fluid from gut
(Jeong et al., 2016).
A systematic review 1450 studies, only 10 were of quality
A decreased survival odds for OHCA patients treated with AAM by EMS personnel compared with
BAM
(Carney et al., 2021)
A systematic review of 99 studies, (630,397) over 30 years
BAM VS SAD VS ETI (CA/trauma) = No difference
Refs:
Bozeman WP, Kleiner DM, Huggett V. A comparison of rapid sequence intubation and etomidate-only intubation in the prehospital air medical setting. Prehosp EmergCare 2006; 10: 8-13
Carney, N., Totten, A. M., Cheney, T., Jungbauer, R., Neth, M.R., Weeks, C., ... & Daya, M. (2021). Prehospital airway management: a systematic review. Prehospital Emergency Care, 1-12.
Deakin, C. D., King, P., & Thompson, F. (2009). Prehospital advanced airway management by ambulance technicians and paramedics: is clinical practice sufficient to maintain skills?.
Gibbison, B., Cook, T. M., & Seller, C. (2008). Case series: protection from aspiration and failure of protection from aspiration with the i-gel airway. British Journal of Anaesthesia, 100(3), 415-417.
Hodkinson, M. (2010). The future of paramedic intubation: who should be responsible?. Journal of Paramedic Practice, 2(8), 358-362.
Jeong, S., Ahn, K. O., & Do Shin, S. (2016). The role of prehospital advanced airway management on outcomes for out-of-hospital cardiac arrest patients: a meta-analysis. The American Journal of Emergency Medicine, 34(11), 2101-2106.
Lockey, D. J., Healey, B., Crewdson, K., Chalk, G., Weaver, A. E., & Davies, G. E. (2015). Advanced airway management is necessary in prehospital trauma patients. British journal of anaesthesia, 114(4), 657-662.
Ridgway, S., Hodzovic, I., Woollard, M., & Latto, I. P. (2004). Prehospital airway management in Ambulance Services in the United Kingdom. Anaesthesia, 59(11), 1091-1094.
Sweeny, K. (2008). Crisis decision theory: decisions in the face of negative events. Psychological bulletin, 134(1), 61.
Wang HE, Davis DP, O’Connor RE, Domeier RM. Drug-assisted intubation in the prehospital setting (resource document to NAEMSP position statement). Prehosp Emerg Care 2006; 10: 261-71
Негізгі бет Basic Vs Advanced Airway management (Decision-Making)
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